老年头颈部癌症患者的治疗耐受性和结局。
Treatment tolerability and outcomes in elderly patients with head and neck cancer.
机构信息
Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Division of Biostatistics, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
出版信息
Head Neck. 2021 Mar;43(3):858-873. doi: 10.1002/hed.26548. Epub 2020 Dec 8.
PURPOSE
The number of elderly patients with head and neck squamous cell carcinoma (HNSCC) continues to grow. Management of this cohort remains poorly defined. We investigated treatment tolerability and clinical outcomes in this underrepresented population.
METHODS
We identified patients aged ≥70 with nonrecurrent, nonmetastatic HNSCC treated curatively from 2007-2018 and analyzed clinical covariates.
RESULTS
Two hundred and twenty patients with a median age of 75 (interquartile range:72-80) were identified. Age and comorbidities were not correlated with toxicity (P ≥ .05). Patients who experienced a treatment interruption had significantly greater weight loss (P = .042) and worse overall survival (OS) (P < .001), but not worse disease-specific survival (P = .45), or locoregional control (P = .21).
CONCLUSIONS
Treatment interruptions were associated with weight loss and worse OS, but not disease related outcomes, suggesting an interruption in the elderly may be a surrogate for another issue. In sum, our data should guide clinical trial design to benefit this growing, neglected cohort.
目的
患有头颈部鳞状细胞癌（HNSCC）的老年患者人数持续增长。该人群的治疗方法仍未得到明确界定。我们研究了这一代表性不足的人群的治疗耐受性和临床结果。
方法
我们确定了 2007 年至 2018 年间接受根治性治疗的年龄≥70 岁、无复发性、无转移性 HNSCC 的患者，并分析了临床相关因素。
结果
共确定了 220 名中位年龄为 75 岁（四分位距：72-80）的患者。年龄和合并症与毒性无相关性（P≥.05）。经历治疗中断的患者体重明显下降（P =.042），总生存期（OS）更差（P <.001），但疾病特异性生存期（P =.45）或局部区域控制（P =.21）无差异。
结论
治疗中断与体重减轻和 OS 更差相关，但与疾病相关结局无关，这表明老年人的中断可能是其他问题的替代指标。总的来说，我们的数据应指导临床试验设计，使这一不断增长的、被忽视的人群受益。
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